Waike lilun yu shijian (Jul 2022)
Economic cost analysis of cholecystectomy based on development of specialization
Abstract
Object To analyze the difference of economics cost between biliary surgeons and general surgeons in performing cholecystectomy for gallbladder benign diseases and the influence of specialization of surgery on patients. Methods The general information, hospitalization expenses and postoperative hospital stay of the patients with gallbladder benign diseases undergoing cholecystectomy from 2009 to 2018 in Zhongshan Hospital were analyzed retrospectively. Results There were 11 635 cases included in this study through the searching notes and manual review dividing 4 350 cases in biliary surgeon group and 7 285 cases in general surgeon group. There was no significant difference in ratio of laparosco-pic surgery between two groups(P=0.198). Total cost in biliary surgeon group was significantly higher than that in general surgeon group during 2009—2018, (15 721.60±9 888.82) yuan vs.(12 529.88±9 382.23) yuan. The increase in operative cost, (5 110.43±1 416.40) yuan vs. (4 601.24±1 601.65) yuan, material cost, (4 458.73±2 967.35 ) yuan vs. (4 080.49±2 377.83) yuan, drug cost, (1 808.32±2 771.20 ) yuan vs. (1 562.51±3 648.92) yuan, self-paying drug cost, (806.63±1 285.11) yuan vs. (637.14±1 071.00) yuan, and nursing cost, (165.24±296.55 ) yuan vs. (129.24±398.01) yuan, P<0.001 were higher significantly in biliary surgeon group than those in general surgeon group. Postoperative hospital stay was longer in biliary surgeon group than that in general surgeon group, (2.51±2.39) d vs. (2.50±2.87) d, P<0.001. After specialized grouping in 2015, the ratio of laparoscopic surgery in biliary surgeon group increased significantly. Total fee and operative cost in biliary surgeon group were higher than those in general surgeon group. However, both drug and nursing cost were lower in biliary surgeon group than those in general surgeon group, and postoperative hospital stay was shorter than that in general surgeon group (All P<0.05). Conclusions Compared with general surgeon group, total cost of cholecystectomy is higher in biliary surgeon group which might be due to the patients with complex disease. Drug and nursing cost are lower, and length of stay is shorter in recent years suggesting a faster recovery.
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